January 2011 Moms

Delivering with an "on-call" doc? Advice/thoughts?

So, my OB doesn't do deliveries anymore as she's been easing the transition into retirement. Which means I will be dealing with the doctor who is on-call. I'm a little nervous about this! I'm wondering if how common it is to have to deal with an on-call in the end, and what I should be doing to make sure that my wants/needs are met?

Up until 28 weeks I was considered "high-risk" and therefor was gearing up for a c-sec, so it wasn't an issue...but the problem has since resolved so now I'm at least attempting to push.

Is this what a "birthing plan" is for? Will the nurses who I deal with and who will be doing the majority of the care, be the ones to reiterate what my wants are? I'm nervous I will have some random walk in and have to yell at him through pushes in order to make sure things aren't being done that I don't want! This is seriously stressing me out since things are getting down to the wire!

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Re: Delivering with an "on-call" doc? Advice/thoughts?

  • I don't have any great advice even though I'm anticipating a similar scenario just because of how my military health care is conducted.  Personally, even without a written birth plan, I'm intending to be VERY clear about what I am comfortable/not comfortable with.  I've also briefed my husband numerous times (and involved him in the decision making process) regarding possible scenarios and interventions and how I'd like them to be approached -- I think it's particularly important when you don't know who will do the delivery that whoever is with you as a partner/birthing coach/doula/etc. is going to help strongly advocate for you.

     Try not to stress!!! 

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  • Another doctor in my ob's practice was on rotation when I delivered my first (they do 24-hour shifts at the hospital so one of them is always there...so it's not exactly a random doctor) and I LOVED him even though it was the first time I met him. I definitely think the nursing staff will be almost more important so hopefully you will be able to talk to the head nurse about your wants. During my labor (which was very short, granted) the doctor really took over when it was time to push and he explained exactly how he wanted me to do it (3 sets of pushes, chin to chest, breathe in between pushes, etc). I had a very smooth delivery so I'm not sure what would have happened otherwise but I can only say I trusted him very much and would have gone along with whatever he suggested as the expert. Definitely lean on the nurses who have tons of experience with labor - they will help you whether you get the epi or not and keep you calm.
  • That is just how it works here, my dr works with a team of 16 dr's and one of them will be at the hospital when I deliver, I have never met any of them except my own.  And unless there are some sort of complications all the dr really does is "catch" the baby, the nurses do the rest.

    I wouldn't stress about it, now i did write a birth plan and I am having a doula, which should increase the chances that the L & D goes the way I would like, but even with all of that it is only good if LO's health and safety allows for it.  

    I would make sure your DH knows your wishes and any other support person you may have with you and just try to relax and go with the flow, putting in your input where it is required.  How many patients does your dr have anyway, would he even remember your specific requests when the time comes? 

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  • I personally requested that whomever delivers me is one of the OB's from the practice I see. There's an OB from another practice that works at my delivering hospital as an on-call only, and I refuse to see him. I wouldn't mind an on-call, honestly, but the reason I asked was because of his track record... two of my co-workers who've delivered via c-section through him have had their babies cut by him during the procedure- one on the face and one on his back, near the spine.

    I don't anticipate a c-section but I know that sh!t happens, and I refuse to let that man cut me open with me hoping that he doesn't cut my child... I'd have to kill him.

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  • There are 4 doctors in my practice, all of whom I've met and had appointments with. They share rotations with a group of doctors at the hospital where I'm delivering.  When I went in at 33 weeks because of severe dehydration there were two doctors on call and one was from my practice.  I will not be doing a birth plan, but will request that I am fully informed and consent to any and all procedures before they are done, regardless of standard at the hospital.  Generally, I just think that there are too many variables to write up a birth plan because in reality every birth is different and I just want to know what the procedures are and whether they do them out of convenience or medical necessity.  I also don't think it really matters who the mystery doctor is unless for some reason that particular doctor doesn't follow my wish to be fully informed prior to being given any drug or procedure (like breaking my water).  Then I will be more than pissed.
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